That’s the impression created by a recent report by East County health care providers on the state of access to care for the uninsured, a number that is increasing significantly as people lose their jobs in the ongoing recession. The report, “Impact of the Economy on Health Access in East Contra Costa County,” contains words such as “dire,” “disturbing,” “stress,” “depression,” “staggering” and “desperate.”
“Health systems are facing potentially catastrophic consequences from the exploding demand and potential shrinking of resources,” states the report’s authors, comprised of leaders of Contra Costa Health Services, John Muir Health, Kaiser Permanente, La Clinica de la Raza, Planned Parenthood Shasta Diablo and Sutter Delta Medical Center.
“The economy will continue to slow and the number of unemployed will continue to rise for at least a year. Rising unemployment means more and more people losing health coverage for themselves and their families. Despite (health care providers’) best efforts, current strategies for addressing the increased need are inadequate. Patients are sicker and more desperate.”
According to County Administrator David Twa, unemployment in the county could increase to 12 percent from the current 9.3. Just 20 months ago unemployment in the county was under 5 percent – at a time when health care providers were complaining about the difficulty in keeping up with the need.
There are numerous examples of how the situation has worsened since then:
• Medi-Cal applications in the county are up 76 percent in 2008 over 2007.
• New patients in the county health system are up 30 percent over last year. The number of active primary-care patients in the county system has increased 50 percent in five years.
• Contra Costa County’s budget deficit, projected over a 15-month period into next year at $56 million, is forcing the county health department to cut $19.5 million from its budget.
• La Clinica has seen a 15-percent increase in patients and visits in the last six months compared to the previous year.
• Planned Parenthood in Antioch saw a 16 percent increase in patients in March over the previous March, and in Pittsburg the patient load was up 11 percent.
• Nearly 10 percent of patients hospitalized at Sutter Delta Medical Center in Antioch in 2008 were uninsured, compared to 6 percent in 2007. An increasing number of patients lacking insurance don’t pay their hospital bill. Many people treated at Sutter’s emergency room have non-emergency conditions that could have been addressed by a primary care doctor.
• Kaiser Permanente has seen a dramatic increase in patients receiving charity care.
The main piece of good news in the gloomy report is the plan by La Clinica to open a primary-care facility in far East County. “With a grant from John Muir/Mt. Diablo Community Health Fund, the organization is engaged in a fast-track planning effort to determine the appropriate location,” the report states.
La Clinica Communications Specialist Janet Luna in a phone interview Wednesday was unable to say when and where the new facility might be provided. “At the moment the plans … are still very premature,” she said. “It’s in the works. Conversations and discussions are happening with stakeholders, but nothing is confirmed yet.”
La Clinica currently operates a facility on Gladstone Road off Leland Road in Pittsburg that mostly serves East County’s Hispanic community.
According to the report, there have been a few other encouraging developments on the health care front:
• Contra Costa Health Services has improved its appointment system, providing 1,200 more appointments per month at its eight health centers in the county, including one in Brentwood and another in Antioch.
• John Muir Health treats more than a dozen people on most Saturday mornings at its Mobile Health Clinic service in Brentwood and far East County. The patients are usually Spanish-speaking, low-income and often undocumented. The clinic operates at other sites in East County during the week in conjunction with the county Health Care for the Homeless program.
• Kaiser Permanente subsidizes health coverage for more than 14,000 low-income residents in East and Central County, including medical, dental and vision care for 2,555 low-income children.
• Sutter Delta Urgent Care Clinic offers a drop-in clinic serving uninsured people from 6 to 10 p.m. daily.
The report concludes by suggesting other strategies for improving care, including supporting La Clinica’s expansion efforts, recruiting more volunteer doctors providing free care and increasing the outreach to the uninsured on their health care options.